Critical illness and injury are leading causes of death and disability world-wide. Communication, synergy, and funding efficiency at a national level improve the breadth and quality of critical illness and injury research. To address these needs and to participate in the global effort to improve patient outcomes, this grant funds the United States Critical Illness and Injury Trials (USCIIT) Group. Its dual missions are to foster investigator-initiated hypothesis testing and to plan strategically at national level. As a "network of networks", the USCIIT Group facilitates collaboration among experts with the goal of promoting clinical trials that improve outcomes for the critically ill or injured. The specific aims include the following: 1) Establish an inclusive, nationwide network of experts to review published data, establish national priorities, vet hypotheses, write clinical protocols, and generate pilot data;2) Promote interaction and synergy across established programs, both academic and non-academic, to improve the robustness of clinical trails and test hypotheses in a US population;3) Provide a venue to educate and train clinicians of all backgrounds in the science of trial design, conduct, analysis, and reporting;4) Insure patient protection and privacy by addressing the ethical, legal, and social implications (ELSI) of research in the specialized circumstance of critical illness or injury. The USCIIT Group is governed by Organizing and Steering Committees. The USCIIT Group meets triannually: every Fall at the NIH Bethesda campus and every Winter and Spring in conjunction with the Annual Congresses of critical illness and injury professional societies. PUBLIC HEALTH RELEVANCE: The United States Critical Illness and Injury Trials (USCIIT) Group fosters investigator-initiated clinical trials and plans strategically at a national level for clinical research.